How does Osteogenesis imperfecta affect dental management?
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How does Osteogenesis imperfecta affect dental management?
Early coverage: Stainless steel crowns on primary molars and full coverage early to prevent wear
Handling: Plan careful transfers and supported positioning.
Stabilization limit: Avoid forceful restraint or any immobilization that cannot be performed safely; AAPD identifies bone fragility as a stabilization risk, and inability to immobilize safely as a contraindication.
Medication review: Review bisphosphonate/other antiresorptive treatment with the medical team.
Infection and prognosis: Preserve a restorable tooth when prognosis supports it; drug exposure does not justify leaving infection untreated.
Risk discussion: Discuss surgical healing and medication-related osteonecrosis risk without treating it as either zero or an automatic extraction ban.
Extractions: handle brittle bone gently and support the jaw.
Before GA: assess cervical spine abnormalities and ask about basilar invagination.
Restoration: anterior teeth may need crowns or composite, with full coverage of permanent teeth later.
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Assess whether a tooth can be predictably preserved. An infected nonrestorable tooth needs definitive care despite antiresorptive exposure; coordinate surgical risk, technique, and healing rather than inventing a drug holiday.
Assess whether a tooth can be predictably preserved. An infected nonrestorable tooth needs definitive care despite antiresorptive exposure; coordinate surgical risk, technique, and healing rather than inventing a drug holiday.